Md. Code Regs. 10.09.30.02

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.30.02 - Definitions

A. The following terms have the meanings indicated.

B. Terms Defined.

(1) "Comprehensive evaluation" means the assessment performed by a nurse or social worker, or both, using the tools designated by the Department, of a participant's medical, social, and functional status by:

(a) Direct observation of the participant;

(b) Contact, as appropriate, with the participant's representative; and

(c) Financial eligibility screening.

(2) "Department" means Department of Health and Mental Hygiene.

(3) "Financial eligibility screening" means the determination of whether an individual qualifies financially as a participant.

(4) "Geriatric Evaluation Services (GES)" means the assessment that is required to admit an individual to a State facility or Veteran's Administration hospital.

(5) "Nurse" means a person who is licensed as a registered nurse in the jurisdiction in which services are provided.

(6) "Nurse practitioner" means a person who is licensed as a nurse practitioner in the jurisdiction in which services are provided.

(7) "Participant" means a Medicaid recipient or an individual who would be able to establish financial eligibility under the Program within 6 months of admission to a nursing facility, whose needs may not be adequately met in an episodic ambulatory care setting, and who may require continuing institutional or community based long-term care services.

(8) "Plan of care" means the written long term care plan composed of a comprehensive evaluation of the participant's health status including:

(a) Pertinent diagnoses;

(b) Psychosocial status;

(c) Functional status; and

(d) Type of services recommended.

(9) "Preadmission Screening and Resident Review (PASRR)" means the screening or reviewing of all individuals with mental illness or intellectual disability who apply to or reside in Medicaid-certified nursing facilities.

(10) "Program" has the same meaning as defined in COMAR 10.09.36.

(11) "Provider" means a local health department, or when necessary, a contracted agency:

(a) Providing the comprehensive evaluation through an appropriate agreement with the Department and identified as a Program provider by the issuance of an individual account number;

(b) Employing nurses and social workers to provide the comprehensive evaluation; and

(c) Demonstrating experience in providing assessment and evaluation services and in developing plans of care.

(12) "Provider agreement" means a contract between the Department and the provider of STEPS specifying the:

(a) Services to be performed;

(b) Methods of operation; and

(c) Financial and legal requirements which shall be in force before Program participation.

(13) "Psychiatrist" means a person who is licensed as a psychiatrist in the jurisdiction in which services are provided.

(14) "Psychologist" means a person who is licensed as a psychologist in the jurisdiction in which services are provided.

(15) "Social worker" means a person who is licensed as a social worker in the jurisdiction in which services are provided.

Md. Code Regs. 10.09.30.02

Regulations .02 adopted as an emergency provision effective October 21, 1986 (13:23 Md. R. 2477); emergency status extended at 14:2 Md. R. 125; adopted permanently effective January 27, 1987 (14:2 Md. R. 129)
Regulation .02 amended effective July 12, 1987 (14:14 Md. R. 1571); January 9, 1989 (15:27 Md. R. 3129); amended and recodified from .01 effective 50:24 Md. R. 1041, eff. 12/11/2023